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I’m on pins and needles this week, anticipating the vote coming Thursday to repeal the ACA. (Just a note that I’m not going to insult anyone’s intelligence by calling this occasion passage of a new healthcare bill; do not be fooled, it is a gutting of the ACA, specifically designed to undercut the mechanisms that make the ACA work)

No one’s more surprised than me that MTV (!) has great coverage on this issue. Maybe the old “they don’t even play music videos!” complaint actually was a sign that they’ve got more substantial things to cover.

“Let’s dispatch the baldest lie first. “Guess they wanted iPhones more” is just a repackaging of the old racist and classist trope that all welfare recipients buy luxury televisions. It’s the new “welfare addicts are living like kings while I work for a living.” And it’s fiction. Technology is cheap now. All of it. Our fancy glowing screens are no longer markers of prosperity or even risky spending: Smartphones are an affordable alternative to personal computers. They democratize access to the internet and therefore to jobs; you can’t play ball in the modern (read: gig) economy without one.

But the iPhone line is a sideshow when you stack it against the big issue, which is how financially fucked most people actually are. When people opt out of health insurance, it is not because they don’t want health care. It’s because they don’t have enough to get by in their daily lives. It’s because $200 tangibly represents gas money or rent or utilities. When I opted out of health care, it was because I was making minimum wage and minimum wage is not enough to live on. It’s not.”

Because pregnant women and infants are so vulnerable– in many ways, they represent the most vulnerable members of our society– their survival is a key indicator of a society’s overall health. And by this measure, we are quite sick.

The maternal and infant mortality rates in the United States, particularly in states like Texas and among certain groups– people of color and the poor– are shockingly high, and getting worse. In Texas, just 11.4% of pregnant women are African-American, but they represent 29% of the state’s maternal deaths. Nationally, the mortality rate for black infants is twice that of white infants.

When I worked in a Louisiana maternity ward, I was shocked to see these outcomes up close. It drove home exactly who is bearing the brunt of these realities, and what the world looks like when you’re living inside these numbers.

At the hospital, we were seeing poor outcomes- and even deaths- mostly for one simple reason: because the underlying population health was so poor. This is despite the fact that the US spends more money on health care than any other country in the world. I’m not chalking these poor outcomes up to bad health during pregnancy, or insufficient prenatal care, although that is a part of it. The reality is more complicated and starts much earlier.

The women that we saw were sick before they became pregnant: diabetes, hypertension (which was present even for many teenagers), poor diet and malnutrition. Some women were also struggling with drug and alcohol addiction and mental illness. Many were experiencing more than one of these conditions. Also present for so many– if not all– of these women: extreme stress, which is a medical condition, and we would be foolish to ignore.

During pregnancy, these predisposing factors led to sky-high rates of gestational diabetes and preeclampsia. Women struggled with insufficient or absent prenatal care, partly due to a lack of knowledge about coverage, and also a lack of providers, hospitals and/or transport in some neighborhoods. The rates of C-section was shockingly high. Their babies were born small, and they were born early — so early, that we cheered any time a mother made it to thirty-five weeks. Their pregnancies were complicated and high-risk, and the resulting negative health conditions continued after they give birth. This is not normal. It is unacceptable.

Because of the color of my skin, I was also witness to the utter apathy of so many of those who have an ability to make a difference. They conflated “common” with “normal” so many times that I stopped keeping track. Just because you see a phenomenon every day does not mean that it is to be expected or accepted. It showed me how little regard we as a society hold for the health of certain women and their families. This is not only morally repugnant, it is criminal.

It’s Mardi Gras tomorrow, which means it’s one of the times where I miss New Orleans the most. Because out here, it’ll just be Tuesday. God, I miss that city; when I think about it I get a real ache in my chest. My shoulders pitch forward, and sometimes it’s hard to breathe.

But back to it. Mardi Gras is a time of celebration, wild behavior, and freedom: a time where no one works and the city takes its time to play, to celebrate itself, its history, its traditions.

There’s that word: tradition. Not unlike its sibling, heritage. In the South, we all know what that means. And Mardi Gras is also a time to remember these systems and how they are reinforced and resurface even (especially?) during times of civic celebration, times of tradition. In a city with such a long and winding history, replete with power shuffles, centuries of intermarriage and isolation between communities, and the most racist and inhumane elements of the deep South, the shadow of Jim Crow continues to lean on the city, stifling its progress, pressing on its back.

In New Orleans, segregation and intolerance take shape in their own way, the present crudely twisted by traditions both remembered and forgotten. Two Krewes continue to hold their balls, but no longer march. They’ve decided that cancelling their parades is preferable to integrating their membership. If there’s one constant, it’s that the past is never really passed.

One way to explore this twisted, deeply fascinating history is through the flambeaux, a familiar fixture to anyone who’s been to a real New Orleans Mardi Gras. The flambeaux are black men who carry propane tanks and torches to light the way for night parades, as floats roll by, carrying bodies which are mostly white underneath carnival masks.

“In the history of New Orleans Carnival celebrations, up until the legal unraveling of racial segregation (and arguably far after), the flambeaux were really the only “sanctioned” and protected way for Black people to cross the metaphysical race line of Mardi Gras. Black families who dared attend parades in the French Quarter or St. Charles Avenue would suddenly find themselves cornered by police dogs… To the entire world, the fabulous parades of Carnival, synonymous with New Orleans’ Mardi Gras, were enjoyed by whites only.”

Every year, I look forward to the annual letter from the Bill and Melinda Gates Foundation.

Either that line made you roll your eyes or it made you smile in recognition, that tiny moment when you find out that nerdiness is shared with someone else.

That’s my favorite thing.

But back to it. Of course this letter is something I look forward to: it’s written about the power of philanthropy, measurement, and progress. It’s about centering the experiences, lives and health of women. It’s about embracing what works, and moving forward, shoulder to shoulder with those you are working to help.

These two are the most exceptional kinds of people. Because they understand implicitly how the lives of others, those living in far-off and remote places, with few resources and no voice– they understand how those lives intersect and impact their own. That we are only as healthy and successful as the most vulnerable us. That’s what community is.

I’ve been having a hard time this week, and asking myself that again and again. At the end of my work day, at the start of each meeting, as I try to summon the motivation to get out of bed each morning. So what? Who cares?

I’ve mentioned before, and I truly believe, that I am paid to do good. I work within a large community foundation, working side by side with colleagues of every stripe to make Oregon a better, more equitable, and healthier place for all. I am shoulder to shoulder with others who share this vision and these values. Being paid to do good is a privilege and a responsibility, and one which I do not take lightly.

And still, as I watch the news roll in, hear of new discriminatory and destructive legislation, and watch with horror as our most vulnerable become targets… as I refresh my screen and watch America fall down around my ears and work to turn the volume down and get back to my projects at hand, I wonder: So what? Who cares?

I’ve been thinking a lot about how I can position my work, the work done by my department, organization and field to do the most good. How can we operate in a way which serves civic purposes, and keeps science, research, openness and learning alive? How we best serve those who need it most? Our work has gone from mostly theoretical, stretching as far as we can see and father, to triage. How do we change our work in response? How quickly can we do this?

As I watch the NEA, PBS, NSF fall apart, and as we all watch the Departments of Defense and Homeland Security fall in line to reinforce this administration’s illegal and un-American actions, I am filled with an overwhelming concern for our core institutions. Since November 8th, I have been thinking about how these four years will be a test of the strengths of our institutions, of our safety net and our values. I could never have anticipated that this would all happen so quickly.

The last few months have been hell for so many people– it’s scary and eye-opening for so many, as we enter the unknown. This week, the first of the new administration, has shown us that our fears are well-founded, and that actions both radical and small will be needed, today and every day for the coming months and years.

But it’s important to recognize that we live in the same country today that we did on November 7th. If you’re just realizing that this country remains deeply racist and sexist, welcome to the party. Let’s chat.

I’ve thought a lot over the past months about a game plan for the next four — or eight– years, and I think that the end of this first week, which has been full of terrifying, confusing and multi-directional Executive Orders, mass delusion, and a total abandonment of facts– is a good time to regroup and revisit this plan.

As someone who has dealt with depression and anxiety my whole life, I know a thing or two about self care, because that’s how I keep going on a daily basis. Here are the things I’m doing to take care of myself and those around me.

Reaching out. For me, this is best done through writing letters, postcards, and notes. I’m sending notes of appreciation, thank yous and thinking-of-yous, and my favorite way to do that is through the mail. Email and text messages work too. For me, creating a daily reminder that we are in this together, and that I have a network of humans that I care about, is a source of immense comfort. It’s also helping me to build a long email list of like-minded people, and I know that will come in handy as I need to mobilize others and get them involved.

Checking in. I’m doing this for neighbors, coworkers, and strangers. So many people are hurting, anxious and scared, cycling through stages of fear and grief, and reeling from hourly news updates. I’m working mindfully to cultivate caring and kindness for others, and working to understand what they are scared about, so that I can support them in the way that they need.

Keeping my money in my community. I live in a place where I can support local grocery stores, fruit/veggie stands, local producers and artisans. Yup, it’s Portland. I encourage anyone who can to get a CSA. Yeah, you’ll spend a few bucks more, but you’re getting the best quality local and organic produce while supporting those in your local community (and I don’t just say this because my brother is a farmer). I know that this isn’t accessible or feasible for everyone. But I would encourage you to do it if you can. It feels fucking good.

Remembering that money talks. I tried to keep this top of mind during the holiday season, but I think it bears repeating. When you’re buying gifts for others, try to purchase items that support your local community rather than corporations. Give gifts that give twice. There are tons of places where you can buy tote bags, shirts, art prints, and jewelry from artists who are donating a portion of their profits to causes that they care about. This is great because you’re giving a gift, supporting an artist, and also giving to a cause, all with the same dollas. Support artists on Etsy, go to craft fairs, shop at local bookstores, do whatever is available to you. Your money means a lot to small proprietors and to artists. And there stuff is really cool, too.

Listening to podcasts. For me, this is a really helpful way to hear as others process this political landscape and consider what it means to be an American. I’m getting so much out of hearing different feminist voices from all over the country. I’ve been listening to Still Processing, Call Your Girlfriend, Speed Dial (that’s on MTV), Dear Sugar, Another Round, and 2 Dope Queens. Their voices give me comfort and hope, and make me feel less alone.

Eating well and getting moving. These are standbys for me, and during the times when my anxiety gets out of control, these the best ways to get me back on track (along with taking my meds, drinking water, and sleeping). Stress gets inside of you, affects how your body functions, and inhibits your brain. It is a real health problem, and cannot be underestimated. Be gentle with yourself. Cook good food for yourself and for others. Go on a hike or a walk, if you are able. Keep moving.

Limiting internet time. This one is so hard, especially as someone who is obsessed with news and media, and terrified of missing out. But it’s been key for me. I’m not on Twitter in the morning or at night; by checking it once or twice a day, I feel that I can get the news I need. I deleted Facebook months ago, and it’s probably the best thing I’ve done for my mental health in the past year. Honestly, the memes will still find their way to you. You won’t be left behind. Delete it.

OK, so that’s the immediate, and that’s what I’ve been especially engaged with for the months since November 8th. Now I’m ready to take action. I live in a blue city and a blue state; I feel pretty isolated from what’s going on in most of the country much of the time, but these things affect all of us, and the privilege that comes from my zip code is no excuse for inaction. There are still tons of things I can do, and the same goes for you, no matter where you live. Here’s what I’m committing to keep doing, long after the memory of President Trump putting his tiny orange hand on the Bible for his swearing-in has faded.

Giving money and time. This is pretty self explanatory, and it’s been repeated often. I’ve chosen to give to a few nonprofits that are small, without stable funding, and unlikely to receive grants from foundations. Those are the organizations where your time and money can go the farthest. There are tons of organizations to support in whatever causes speak to you. As far as political contributions, I have a different take than many others do. Remember that HRC raised and spent much more money than her opponent, but she still lost the election (eh, lost the electoral college). For politicians, particularly those who are not local, I prefer to give time over money, whether it’s canvassing, phone banking, or just talking to family members and encouraging them to vote. That’s where I feel my efforts are most valuable.

Subscribing to listservs and newsletters. This can be a great way to become involved with certain causes, and to see what’s going on and where you can fit in. It’s also a good way to continue being reminded about and involved in efforts in an ongoing way.

Become familiar with available resources. There are lots of great resource lists out there, and really important conversations are happening right now. It’s important to understand the concerns of other communities. Many are experiencing a state of fear and seeing a bleak reality; for some, they have always lived with this, and it’s nothing new. Become familiar with their concerns about what’s to come under the Trump Administration. Listen to understand. Do this work so that you can support and protect those around you.

Sign petitions and make phone calls. There are lots of petitions out there; whitehouse.org and change.org are good, well-known sources. Set aside a few minutes each day or week to sign something. It’s really quick. Phone banking on behalf of candidates, advocacy groups, and causes is also incredibly easy, and I say this as someone who will do almost anything to avoid talking on the phone. In my experience with phone banking, people are way nicer that you expect. Both of those things are easy to neglect, so for me, it’s easiest if I add these things to my regular tasks — pay my heat bill, write a rent check, sign a petition. Make it a habit.

Draft letters to send to your representatives. I find it really helpful to have a generic template on hand. With a template, I can quickly make my views known, whether it’s in support or against a given issue or bill. I’m not creating something to just cut or paste, but having a jumping-off point can be the difference between writing or not writing at all. This is also something you can share with others, and another way to lower their barriers to becoming involved.

Look after your health. This is especially true if you are covered under the ACA, and at acute risk of losing coverage. Get your annual exam. Get an IUD (I am in love with mine, it’s one of my most successful relationships to date). Get your HPV vaccine. Stock up on Plan B (for yourself or others). Do it, and do it now.

Don’t fuck Republicans. OK, let me explain this one. It means: don’t ignore the politics of those close to you. Even if your Trump-voting friends, family or boyfriends don’t identify themselves as racists or misogynists, they have emboldened a demagogue with actively discriminatory views and policies. Do not give them a pass. Trump voters have put their humanity above the humanity of others. Period. Now it’s your job to call them out whenever you can. If you want to work to educate them, then be specific, personal and forceful. Saying nothing is the same as endorsement, and I’m frankly done with niceness. It has gotten us nowhere. Tell them exactly how the election of this administration has made you and your community feel afraid and feel less than. And definitely stop fucking Republicans. You really shouldn’t have been doing that in the first place.

Assess your risk and the degree to which you can speak up. For me, this has been perhaps the biggest shift post-election. I am a white cis straight woman and a US citizen. I have access to financial and other resources. I live in one of the most liberal cities in the country; my family and close friends are liberal; my employer has a strong commitment to social justice. What does all of this mean? It means I have literally no excuse not to make my voice heard, and to amplify the voices of those around me who do not have these privileges. The personal consequences for me to speak out are exponentially smaller than they are for others. Shit is about to get really bad. What are you going to be able to shoulder, and what are you willing and able to risk? Be honest with yourself. Set up what you need, whether you will be working behind the scenes or out protesting or organizing. We are all at different places with different limitations, and that’s ok. We are all going to need each other.

Ask friends what they are doing. What organizations, candidates, or causes are they supporting? Ask how you can help, and take action in any way you can. Get familiar with what those around you are doing, and organize around that. This can be particularly helpful if you live in a blue state, but your friends / family live in red states. Support their work, and start helping immediately.

Support those who step up. We are beginning to see this take shape, but no one can predict what media outlets, public figures, and politicians are going to take a strong stance against the Trump Administration. I was continually disappointed during the election cycle by the media and spineless politicians on both sides of the aisle. But whoever does step up, that’s who I’m going to support, and I’ll do so as visibly as I can. Again, money talks here; this could mean paying for a newspaper subscription, giving a political donation, or consuming art from certain artists. Pay attention to who speaks out, and notice who says nothing.

Talk to the white people in your life. Does this one need explaining? People of color, Muslims, LGBTQ+ people — marginalized people have been telling us, and some for lifetimes, about the hardships they face. But here’s the thing. It should not the responsibility of minority communities to educate others or to sound the alarm. If you are white, talk to the white people in your life, because they might actually listen to you. Hold them accountable. It’s beyond time for us to get our people and to do better.